Cited by 1,485Mental Health Treatment and AccessTreatment of Major DepressionChild and Adolescent Psychosocial and Emotional Development

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The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey

Dan German Blazer, Ronald C. Kessler, Katherine A. McGonagle, Marvin S. Swartz·1994·American Journal of Psychiatry

DOI 10.1176/ajp.151.7.979

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Abstract

OBJECTIVE: Major depression is a frequent and disabling psychiatric disorder in the United States. This report examines the prevalence and risk factor profile of both pure and comorbid major depression according to data from the National Comorbidity Survey. METHOD: To estimate the prevalence of psychiatric comorbidity in the United States, a national sample of 8,098 persons 15-54 years of age from the 48 conterminous states was surveyed with a modified version of the Composite International Diagnostic Interview. RESULTS: From the survey data the prevalence of current (30-day) major depression was estimated to be 4.9%, with a relatively higher prevalence in females, young adults, and persons with less than a college education. The prevalence estimate for lifetime major depression was 17.1%, with a similar demographic distribution. Both 30-day and lifetime prevalence estimates were higher than estimates from the earlier Epidemiologic Catchment Area study. When pure major depression was compared with major depression co-occurring with other psychiatric disorders, the risk factor profiles exhibited clear differences. CONCLUSIONS: These findings suggest a greater burden of major depression in community-dwelling persons than has been estimated from previous community samples. The risk factor profile showed significant differences between persons with pure and combined major depression.

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BackgroundInfluential
Accumulation of major depressive episodes over time in a prospective study indicates that retrospectively assessed lifetime prevalence estimates are too low
Patten, S. B. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-19 · Cited by 96
“Higher values have been reported in the US: 16–18% [3,4].”
Racial differences in depression in the United States: how do subgroup analyses inform a paradox?
Barnes, D. M., Keyes, K. M., & Bates, L. M. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0718-7 · Cited by 113
“[1] found a lower prevalence of lifetime major depression in Blacks compared with Whites in all subgroups defined simultaneously by age and gender.”
Background
Self-reported diabetes and posttraumatic stress disorder among adults in the community
Goodwin, R. D., & Davidson, J. R. T. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2004.07.013 · Cited by 100
Depression and functional outcome in patients with brain tumors: a population-based 1-year follow-up study
Mainio, A., Hakko, H. H., Niemelä, A., Koivukangas, J. P., & Räsänen, P. K. (2005) · Journal of neurosurgery · doi:10.3171/jns.2005.103.5.0841 · Cited by 102
Neonatal Fluoxetine Exposure Affects the Neuronal Structure in the Somatosensory Cortex and Somatosensory-Related Behaviors in Adolescent Rats
Lee, L. (2009) · Neurotoxicity Research · doi:10.1007/s12640-009-9022-4 · Cited by 103
“Depressive disorders are often experienced among women during their childbearing years (Blazer et al. 1994).”
Background
The prevalence and correlates of workplace depression in the national comorbidity survey replication
Kessler, R. C., Merikangas, K. R., & Wang, P. S. (2008) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e31816ba9b8 · Cited by 96
Self-citation
History and symptoms of depression among smokers during a self-initiated quit attempt
NIAURA, R. S., DiBenedetti, D. B., Borrelli, B., Shadel, W. G., Abrams, D. B., & Goldstein, M. R. (1999) · Nicotine & Tobacco Research · doi:10.1080/14622299050011371 · Cited by 99
Sickness absence due to depressive symptoms
Koopmans, P. C., Roelen, C. A. M., & Groothoff, J. W. (2007) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-007-0243-7 · Cited by 97
“Blazer et al. (1994) found an overall mean duration of 22.6 weeks by means of a diagnostic interview.”
BackgroundMethodInfluential
Short version of the CES-D (Burnam screen) for depression in reference to the structured psychiatric interview
Tuunainen, A., Langer, R. D., Klauber, M. R., & Kripke, D. F. (2001) · Psychiatry Research · doi:10.1016/s0165-1781(01)00278-5 · Cited by 99
A fuzzy cognitive map of the psychosocial determinants of obesity
Giabbanelli, P. J., Torsney-Weir, T., & Mago, V. (2012) · Applied Soft Computing · doi:10.1016/j.asoc.2012.02.006 · Cited by 98
Child Behavior Checklist Findings Further Support Comorbidity between ADHD and Major Depression in a Referred Sample
Biederman, J., Faraone, S. V., Mick, E. O., Moore, P. S., & LELON, E. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199606000-00013 · Cited by 98
Intimate Partner Violence: How Does it Impact Major Depressive Disorder and Post Traumatic Stress Disorder among Immigrant Latinas?
Fedovskiy, K., Higgins, S., & Paranjape, A. (2008) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-007-9049-7 · Cited by 96
“Although not one of our declared study objectives, our results do suggest that the rates of MDD and PTSD among immigrant Latinas seen in a primary care clinic is very high, relative to data from the general US population of women [14, 15, 20, 21].”
BackgroundResult
The Prevalence and Correlates of Lifetime Psychiatric Disorders and Trauma Exposures in Urban and Rural Settings: Results from the National Comorbidity Survey Replication (NCS-R)
McCall‐Hosenfeld, J. S., Mukherjee, S., & Lehman, E. B. (2014) · PLoS ONE · doi:10.1371/journal.pone.0112416 · Cited by 95
“studies found the prevalence to be equivalent across various geographic indicators such as region and rurality [20,21].”
BackgroundResult
Sociodemographic and psychiatric predictors of attrition in a prospective psychiatric epidemiological study among the general population. Result of the Netherlands Mental Health Survey and Incidence Study-2
de Graaf, R., van Dorsselaer, S., Tuithof, M., & ten Have, M. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.05.012 · Cited by 96
Antecedents and socioemotional consequences of physical punishment on children in two-parent families.
Eamon, M. (2001) · International Journal of Child Abuse & Neglect · doi:10.1016/s0145-2134(01)00239-3 · Cited by 113
Antidepressant‐like effects of fenofibrate in mice via the hippocampal brain‐derived neurotrophic factor signalling pathway
Jiang, B., Wang, Y., Wang, H., Song, L., Huang, C., Zhu, Q., Wu, F., & Zhang, W. (2016) · British Journal of Pharmacology · doi:10.1111/bph.13668 · Cited by 97
“Depression is a highly debilitating and life-threatening mental disorder that occurs in about 17% of the general population, and causes huge costs to society (Blazer et al., 1994).”
Background
Cardiac rehabilitation I
Grace, S. L., Abbey, S. E., Shnek, Z. M., Irvine, J., Franche, R., & Stewart, D. E. (2002) · General Hospital Psychiatry · doi:10.1016/s0163-8343(02)00178-0 · Cited by 96
“Cardiac rehabilitation programs have beneficial effects in the following domains: mortality, exercise tolerance, functional capacity, lipid levels, blood pressure, symptoms of angina and dyspnea, weight loss, smoking behavior, stress level and psychosocial functioning [11-13].”
Background
Acculturation and depression among Hispanics: The moderating effect of intercultural competence.
Torres, L., & Rollock, D. (2007) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/1099-9809.13.1.10 · Cited by 95
Social anxiety disorder as a risk factor for alcohol use disorders: A prospective examination of parental and peer influences
Buckner, J. D., & Turner, R. J. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.09.018 · Cited by 104
“N IH -PA Author M anuscript N IH -PA Author M anuscript N IH -PA Author M anuscript most NCS disorders, including affective disorders (Blazer et al., 1994), anxiety disorders (Wittchen et al., 1995; Wittchen et al., 1996), addictive disorders (Nelson et al., 1996; Warner et al., 1995), and PTSD…”
Background
Developmental Trajectories of Boys’ and Girls’ Delinquency: Sex Differences and Links to Later Adolescent Outcomes
Miller, S., Malone, P. S., & Dodge, K. A. (2010) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-010-9430-1 · Cited by 94
“Unlike antisocial behavior where boys outnumber girls, females are more likely to meet criteria for lifetime depression than males (Blazer et al. 1994).”
Lack of a close confidant, but not depression, predicts further cardiac events after myocardial infarction
Dickens, C. M., McGowan, L., Percival, C., Douglas, J., Tomenson, B., Cotter, L., Heagerty, A. M., & Creed, F. H. (2004) · Heart · doi:10.1136/hrt.2003.011668 · Cited by 95
Differentiating DSM-IV Anxiety and Depressive Disorders in the General Population: Comorbidity and Treatment Consequences
Ohayon, M. M., Shapiro, C. M., & Kennedy, S. H. (2000) · The Canadian Journal of Psychiatry · doi:10.1177/070674370004500207 · Cited by 95
CRH, Stress, and Major Depression: A Psychobiological Interplay
Claes, S. J. (2004) · Vitamins and hormones · doi:10.1016/s0083-6729(04)69005-4 · Cited by 93
Risk Factors for Depression After a Disaster
Person, C. L., Tracy, M., & Galea, S. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000235758.24586.b7 · Cited by 94
“We also found that the prevalence of current past month major depressive episode was 3.9%; this compares to estimates of current major depressive episode in the general population of 2.2% to 4.9% documented in other work (Blazer et al., 1994; Regier et al., 1993).”
ResultInfluential
Serum IL-6, albumin and comorbidities are closely correlated with symptoms of depression in patients on maintenance haemodialysis
Hung, K., Wu, C.-C., Chen, H.-S., Ma, W., Tseng, C., Yang, L.-K., Hsieh, H.-L., & Lu, K. (2010) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfq411 · Cited by 101
Assessing the utility of intermediate phenotypes for genetic mapping of psychiatric disease
Flint, J., Timpson, N. J., & Munafo, M. R. (2014) · Trends in Neurosciences · doi:10.1016/j.tins.2014.08.007 · Cited by 98
Anxiety and risk for substance dependence among late adolescents/young adults
Lopez, B., Turner, R. J., & Saavedra, L. M. (2004) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.03.001 · Cited by 93
The temporal relationship between emotional distress and cigarette smoking during adolescence and young adulthood.
Orlando, M., Ellickson, P. L., & Jinnett, K. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.69.6.959 · Cited by 95
Augmenting Antidepressant Medication Treatment of Depressed Women With Emotionally Focused Therapy for Couples: A Randomized Pilot Study
Denton, W. H., Wittenborn, A. K., & Golden, R. N. (2012) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2012.00291.x · Cited by 102
Depression and Low-Income Women: Challenges for TANF and Welfare-to-Work Policies and Programs
Lennon, M. C., Blome, J., & English, K. C. (2001) · doi:10.7916/d8029184 · Cited by 94
“Those without a high school education are 6.8 times more likely than college educated individuals to experience a depressive episode concurrently with another psychiatric disorder in the past month (Blazer et al., 1994).”
Influential
TOBACCO CESSATION AMONG PATIENTS WITH DEPRESSION
Covey, L. S. (1999) · Primary Care Clinics in Office Practice · doi:10.1016/s0095-4543(05)70124-x · Cited by 93

Authors: Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S.
Affiliations: Duke Medical Center (US)
ORCID: Dan German Blazer
Ronald C. Kessler
Marvin S. Swartz
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 1994-07-01
Volume: 151
Issue: 7
Pages: 979-986
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/ajp.151.7.979
OpenAlex: W2181560023
Cited by: 1,485
References: 24
Citations by year: 2026: 7 · 2025: 11 · 2024: 20 · 2023: 17 · 2022: 20 · 2021: 16 · 2020: 26 · 2019: 33 · 2018: 38 · 2017: 42 · 2016: 50 · 2015: 49 · 2014: 57 · 2013: 71 · 2012: 57
FWCI: 39.36
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (R01MH046376, NIMH MH-00507, MH 46376)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: major depressive disorder, prevalence, psychiatric comorbidity, risk factors, lifetime prevalence, community-dwelling adults, sex differences, young adults, educational attainment, National Comorbidity Survey
MeSH terms: Adolescent, Adult, Age Factors, Mental Disorders, Depressive Disorder, Educational Status, Female, Health Surveys, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, United States, Comorbidity, Prevalence

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The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey

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